Patient Already Lost One Implant: What Treatment Plan is Best?

Locators for maxilla are no succesful

then this case isnt for you! refer out!

the dentist has taken an impression of the abutment in situ thats why it looks like it does on the right side. Like conventional crown and bridge.

sounds like you should refer out!

no i am making sense. I think with all due respect it sounds like your not confident in a solution for this patient. Its simple: -restore ailing implants with a locator with a full palate; locator abutments on minimum retention. Minimum retention to not overload implants and full palate if you loose one or all -at least she has soemthing to wear. -Take them all out!!-would you do that. They are the only options. Would you be happy completing this treatment on a family member confidently ?? if not refer out!! Plus by the sounds of your questions with all due respect they are not of an experienced implantologist. You shouldn't be doing this case, start small work yourself up with courses etc etc . It might sound firm but it will save you the hastle!!

i just think you don't like what i have suggested if you read my comments they similar to others maybe if you hadnt said locators?!!! the implants are only half a way in the bone i wouldnt have called you -yes they are in bone and integrated so restore palliatively as above!!! or refer out -that aint hard to understand!

it is nothing personal my friend and I never mentioned locators any where!!!! You still making no sense academically and try to put my qualifications, which you don't know anything about in question. Sorry I cannot take you seriously...

Academically : Dr T O Booth BDS Hons VuManc MSc OMFS PGDip (Implantiology) -where i come from that means you have teh qualifications to do implants and oral surgery!!!!! Sometime sthere is not an academic answer to everything. This a practical problem with a practical solution. Don't try and augment around these implanst it will not work. They look like Nobel replace select - which have a ti unite surface; which is WELL DOCUMNETED that is less favourbale for augmentation. Therefore if you were to augment yyou would grind the threads off first. THIRD LINE YOU MENTION LOCATORS!!!!!!!!!!!! Like i siad the best options are , -restore ailing implants with a locator with a full palate; locator abutments on minimum retention. Minimum retention to not overload implants and full palate if you loose one or all -at least she has soemthing to wear. Also distributes loads better. -Take them all out!!-would you do that?? Depends how old the patient is if young less than 50 then removal is possibly a better option. Then replace after soft then hard tissue augmention. Please don't make offensive comments when all i am trying to do is help you in this mess!!!!!!

Thank you for your help. Now I can understand what you meant, because finally you decided to elaborate your points!!! I will consider your advice for treatment planning this patient. I got to get the brand and type of the placed implant and remove the bridge first to check the path of insertion of those implants and their suitability for locators. Can you point me to the studies about ti unite surface? I think these implants the way they are now will last no longer than 3 more years with or without the overload. By then the boneloss would be much more significant.